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Too little Vitamin D puts your heart at risk

One of the most potent hormones for suppressing the renin-angiotensin system that regulates blood pressure, a deficiency in Vitamin D is associated with increased risk of CVD, writes Dr Praveen Sadarmin
Last Updated 05 March 2022, 19:08 IST

Globally, cardiovascular disease (CVD) is the number one cause of death, being responsible for approximately 30% of deaths worldwide. Urbanisation and a westernised lifestyle are thought to play a major role in the development of CVD. CVD not only causes significant mortality but also significant morbidity affecting people, their near and dear ones with financial, social and emotional turmoil. Any intervention to alleviate the risks and improve cardiovascular health is welcome. Modifying the risk factors associated with CVD is the first step in addressing this problem. Traditional risk factors like diabetes, high blood pressure, smoking and tobacco consumption, alcohol and recreational drug use, physical inactivity and stress modification go a long way in the fight against CVD.

Vitamin D has been one of those food/medical supplements that have been touted as the elixir of many things. There is a growing body of evidence to suggest adequate Vitamin D status is required for optimal health. Indeed it has been one of the forerunners experimented in new therapies but has also found success in treating/reducing the risk of many health ailments. Where there has been no outright success, it has at least shown some positive benefit. Prominent examples include the treatment of Covid-19 which continues to ravage the world. It has been tried in treating cancers, neurological conditions including Parkinson’s and dementia, Type 2 diabetes, bone health, dyslipidemia, depression, inflammatory conditions and skin diseases like psoriasis to name a few. All the studies either have looked into the effect of Vitamin D deficiency on that particular disease or treated the disease with Vitamin D irrespective of their body levels. It must be emphasised that though some of these studies are positive, the key underlying message seems to be that Vitamin D deficiency is bad for our health. The evidence is rather weak for those studies that used Vitamin D treatment irrespective of the baseline levels.

Obesity, inflammation & Vitamin D

Obesity is associated with lower Vitamin D levels. It is well known that inflammation levels are high in obese people. The combination of obesity, high inflammation and low Vitamin D levels leads to increased morbidity and mortality among these individuals. Experimental studies have shown Vitamin D supplementation to block the inflammatory pathway. These factors indirectly affect cardiovascular health.

Vitamin D appears to be necessary for the production of insulin and is likely to play an important role in diabetes which in turn has an effect on cardiovascular health. Vitamin D is one of the most potent hormones for suppressing the renin-angiotensin system and thus for regulating blood pressure.

The vascular effects of Vitamin D also include inhibition of thrombosis and arterial calcification. There is increasing evidence that systemic inflammation plays an important role in the development of atherosclerosis — the anti-inflammatory properties of Vitamin D may thwart this process. Available data indicate that low solar UV-B exposure and/or low 25(OH)D concentrations are associated with an increased risk of CVD.

Vitamin D & supplementation

Vitamin D status is largely influenced by season, geographic latitude, daily outdoor activities, and the percentage of body surface exposed to the sun. A significant proportion of the population in Europe and North America have Vitamin D concentrations in the deficiency range (25[OH]D < 25 nmol/l).

Although India has abundant sunshine and therefore easily available Vitamin D, the urban population is still deficient in this vital vitamin and supplements are prescribed accordingly. Although exposure to UVB radiation (sunlight) is the most effective means of increasing Vitamin D levels, there is a significant risk of skin cancers associated with it and is not recommended.

Therefore diet supplementation remains the most effective way of increasing your levels. Fortification of food is an easy and effective way of targeting the population which is already happening in many countries including India.

(The author is an interventional cardiologist.)

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(Published 05 March 2022, 18:47 IST)

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